法国医学工作者日前宣布，他们已于近日对一名面部被狗严重咬伤的妇女实施了世界首例异体局部面部移植手术，这意味着他们正在向一个风险重重的医学新领域逐步迈进。

    据美联社11月30日报道，这名38岁的妇女不愿意透露自己的姓名，上周日（11月27日）她在法国北部城市亚眠的一家医院接受了手术，一名脑死亡捐赠者的鼻子、嘴唇和下巴被移植给了她。今年5月份，这名妇女因为被狗咬伤而“严重毁容”，这令她说话及咀嚼食物都变得非常困难。实施手术的工作人员中包括一位在器官移植领域鼎鼎大名的法国外科专家—— 吉恩-迈克尔·杜伯纳德医生。

    周三（11月30日），该医院发表声明说“目前，患者的总体情况非常好，移植器官看起来也不错。”杜伯纳德医生没有透露手术的具体细节，但他证实移植的器官包括鼻子、双唇和下巴。他说：目前，我们仍无法确定患者何时才能出院。”而与此有关的一个新的商讨会议计划于本周五举行。

    中国科学家也曾进行过头皮和耳朵的移植手术，但专家对此表示，嘴部及鼻子才是面部器官中最难被移植的部分。2000年，杜伯纳德医生曾完成了世界首例双前臂移植手术。

    报道说，人们对这一手术所持观点也不尽相同。有人对此表示赞扬，而另外一些人则对手术所具有的潜在危险及它涉及到的伦理道德和心理方面的内容发出了冷静的警告。如果这一手术最后被证明取得了成功（可能要经过数月甚至数年才可定论），手术过程会给那些因烧伤、意外事故或因其它伤害事件导致外貌严重受损的人们带来希望。

    而人们对于完整面部移植术或局部移植术的主要担心则源于器官的排斥反应，这可以导致被移植的皮肤脱落。面部移植的并发症还包括感染情况的发生，这会导致新移植的脸部皮肤变黑，因此需要患者接受第2次移植手术或皮肤再造手术。同时，接受移植的病人还必须终身服用抗排斥反应的药物，而这则会增加肾脏损伤和患癌症的危险。而对于在移植手术失败的情况下，病人的情况是否会因此恶化，医生们也不得而知。

    正是出于对上述问题的担心，英国尝试进行此类手术的计划被推迟。去年，法国道德规范权威人士也拒绝了一份试图进行完整面部移植手术的申请。但他们允许科学家进行涉及到嘴部和鼻子等重要器官的局部移植术。而此前人们也并未进行过一例完整的面部移植手术。

    目前，世界范围内的科学家们正致力于完善面部移植技术。一些医学工作者还实施了一些自体局部面部移植手术，即用患者自身的皮肤进行面部移植，这种移植方法的好处就是不需要服用抗排斥药物。

    除面部移植手术外，各国科学家们还在努力探讨其它身体器官的移植技术。1976年，杜伯纳德医生实施了欧洲首例胰腺移植；1998年，他带领其他工作人员完成了一例手部移植术；2000年1月，他们又进行了世界首例双前臂移植手术。

    那名接受手部移植的病人名叫克林特·哈勒姆，是新西兰人。手术后，因为哈勒姆没有按要求服用必须的药物及他的身体对移植器官产生了排斥反应，最后不得不将移植的器官切除掉。相比起来，另外一名接受移植手术的患者就幸运多了。接受了双前臂移植的法国患者丹尼斯2003年表示，他恢复状况很好，甚至都可以给自己刮胡子了。

    另外，中国南京金陵医院的医生们也在2003年9月份，对一位患有晚期皮肤癌的72岁老年妇女实施了双耳、部分头皮以及其它面部皮肤的移植手术。器官捐赠者来自一位脑死亡的年轻男子。

    Doctors in France said they had performed the world's first partial face transplant, forging into a risky medical frontier with their operation on a woman disfigured by a dog bite.

    The 38-year-old woman, who wants to remain anonymous, had a nose, lips and chin grafted onto her face from a brain-dead donor whose family gave consent. The operation, performed Sunday, included a surgeon already famous for transplant breakthroughs, Dr. Jean-Michel Dubernard.

    "The patient's general condition is excellent and the transplant looks normal," said a statement issued Wednesday from the hospital in the northern city of Amiens where the operation took place. Dubernard would not discuss the surgery, but confirmed that it involved the nose, lips and chin.

    "We still don't know when the patient will get out," he said. A news conference is planned for Friday.

    Scientists in China have performed scalp and ear transplants, but experts say the mouth and nose are the most difficult parts of the face to transplant. In 2000, Dubernard did the world's first double forearm transplant.

    The surgery drew both praise and sobering warnings over its potential risks and ethical and psychological ramifications. If successful — something that may not be known for months or even years — the procedure offers hope to people horribly disfigured by burns, accidents or other tragedies.

    The woman was "severely disfigured" by a dog bite in May that made it difficult for her to speak and chew, according to a joint statement from the hospital in Amiens and another in the southern city of Lyon where Dubernard works.

    Such injuries are "extremely difficult, if not impossible" to repair using normal surgical techniques, the statement said.

    "For pushing the bounds of science, they are to be applauded, as long as they have got full informed consent from the patient and the donor's family," added Dr. Iain Hutchison, chief executive of the London-based Facial Surgery Research Foundation.

    Scientists around the world are working to perfect techniques involved in transplanting faces. Today's best treatments leave many people with facial disfigurement and scar tissue that doesn't look or move like natural skin.

    A complete face transplant, which involves applying a sheet of skin in one operation, has never been done before. The procedure is complex, but uses standard surgical techniques.

    Critics say the surgery is too risky for something that is not a matter of life or death, as regular organ transplants are.

    The main worry for both a full face transplant and a partial effort is organ rejection, causing the skin to slough off.

    "It is not clear whether an individual could be left worse off in the event that a face transplant failed," said Dr. Stephen Wigmore, chair of the ethics committee of the British Transplantation Society.

    Complications also include infections that turn the new face black and require a second transplant or reconstruction with skin grafts, perhaps even one or two years later.

    Drugs to prevent rejection are needed for life and raise the risk of kidney damage and cancer.

    Such concerns have delayed British plans to attempt the operation. In France, ethics authorities rejected an application to try a full face transplant last year, but left the door open for a partial procedure involving the mouth and nose.

    In the United States, the Cleveland Clinic is among those planning to attempt a face transplant.

    The French surgery "doesn't change our plans," said Cleveland surgeon Dr. Maria Siemionow. "We are really looking for the right candidate," which she described as "severely disfigured patients which have already had the conventional treatment" and for whom a transplant is the last chance.

    Dubernard, who is also a lawmaker in France's lower house of parliament, collaborated in the operation with the Amiens hospital's Dr. Bernard Devauchelle. Weekly news magazine Le Point reported that the recipient lives in Valenciennes, in northeast France, and that the donor's facial organs were removed in a hospital in Lille, about 60 miles from where the transplant was performed.

    In 1976, Dubernard performed Europe's first pancreas transplant. He also led teams that performed a hand transplant in September 1998 and the world's first double forearm transplant in January 2000.

    The hand transplant recipient, New Zealander Clint Hallam, later had it amputated. Doctors said he failed to take the required drugs and his body rejected the limb. The double-forearm recipient, Denis Chatelier from France, said in 2003 that he had regained "normal usage" of his hands and was even able to shave himself. His forearms were severed in a model rocket accident.

    Doctors from Jinling Hospital in Nanjing, China, reported that in September 2003, they transplanted two ears, part of the scalp and other facial skin from a brain-dead young man to a 72-year-old woman with advanced skin cancer. Four months later, there were no signs of rejection or tumor recurrence, but it is not known how the patient fared after that.

    Doctors around the world have performed partial face transplants using the patients' own skin, but these don't require anti-rejection drugs.